Historical evolution of thyroid surgery: from the ancient times to the dawn of the 21st century.

Thyroid diseases (mainly goiter) have been recognized for more than 3500 years. Knowledge of the nature of these diseases was, of course, limited at that time. Thyroid surgery was conceived by the ancients, but it was limited to rare attempts to remove part of an enlarged thyroid gland in cases of impending death by suffocation or, in very rare cases, of a suppurating thyroid. Like other fields of surgery, thyroid surgery was limited by many problems: the lack of anesthesia and antisepsis, the need for appropriate instruments, mainly artery forceps (many deaths after thyroid surgery were due to severe postoperative hemorrhage or infection). Much of the progress in thyroid surgery occurred in Europe during the second half of the 19th century. During the first half of the 20th century, the evolution of thyroid surgery accelerated significantly, based on the contributions of pioneering European and American surgeons. The present status of thyroid surgery was established during the last quarter of the 20th century, when modern imaging methods and technological advances (including progress in applied molecular biology) brought thyroid surgery into the new millennium.